Skip to main content
2025 ASCRS Annual Scientific Meeting Main banner
Final Program


Visit ASCRS U
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Self-Assessment
Self-Assessment
Social
Social
Industry
Industry
Back

Session: ePoster: Rectal Cancer 10 (Tue8)

EP973 - Novel Beyond TME (Signet Approach) in patients undergoing APR for locally advanced rectal cancer with Signet histology: A retrospective study

Tuesday, May 13, 2025
8:27 AM – 8:32 AM PT

    Author(s)

  • AS

    ANKIT SHARMA, MBBS, MS, MCH

    ASSISTANT PROFESSOR
    TATA MEMORIAL HOSPITAL, MUMBAI
    Tata Memorial Hospital, Mumbai
    MUMBAI, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AN

    Aditya Kishore Ninjoor, n/a

    Third year surgical oncology resident
    Tata memorial hospital, homi bhabha national institute, mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

  • MK

    MUFADDAL K. KAZI, MBBS, MS, MCH

    Associate Professor
    Tata memorial hospital, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

  • AD

    ASHWIN DESOUZA, MBBS, MS, MCh

    Professor
    Tata Memorial Center, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

    • ePoster Presenter(s)

  • Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai

    Professor
    Division of colorectal Surgeon, Department of Surgical oncology
    Tata Memorial hospital , Mumbai
    Mumbai, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
ANKIT SHARMA, MBBS, MS, MCH: This individual has no financial relationships with ineligible companies.
Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: A previous study comparing long-course chemoradiation (CTRT) with short-course radiation (SCRT) plus 12 weeks of chemotherapy for high-risk locally advanced rectal cancer (LARC) showed no significant differences in treatment failures or disease-free survival (DFS). High rates of peritoneal progression and relapses were observed. The effectiveness of total mesorectal excision (TME) in preventing recurrences specifically for signet ring cell carcinoma (SRCC) remains unclear. This study aims to evaluate whether the Signet Approach or the traditional TME approach results in better outcomes for patients with SRCC undergoing Abdominoperineal resection (APR).

Methods/Interventions: A retrospective analysis was performed using a prospectively collected surgical database from January 2015 to June 2023 at a tertiary care center. The study included 58 patients with MRF positive adenocarcinoma of the rectum, who underwent APR with the Signet Approach and 87 patients who underwent standard TME for SRCC. The Signet Approach, which involves a wider excision beyond S3/4 nerves and Denonvilliers' fascia in view of LVI and PNI , was compared to the traditional TME. Patient characteristics such as demographics, clinical T stage, lateral node involvement, type of radiotherapy (RT), interval between RT and surgery, and number of neoadjuvant chemotherapy cycles were analyzed. Primary outcomes included recurrence rates (local, distant, and combined), while secondary outcomes were 1-year DFS and 1-year overall survival (OS).

Results/Outcomes: Patient characteristics were similar between the groups. The Signet Approach group had a higher proportion of patients receiving SCRT, but this difference was not statistically significant. Recurrence rates were significantly lower in the Signet Approach group (29%) compared to the TME group (52.87%), (p-value of 0.002). Distant failure was noted in 76.5% in the signet approach vs 68% in the TME group. With a median follow up of 29.14 months, the 2 yr OS were 82 % in signet arm vs 77 % in TME arm (95% CI, p value = 0.29) and 2 y DFS were 58 % in signet arm vs 53% in TME arm (95% CI, p value = 0.19)

Conclusion/Discussion: The Signet Approach significantly improved loco-regional recurrence rates, however this did not translate to a survival advantage with most patients having distant disease failure.